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NPI Code Detail

MEDICARE: SOCA IMAGING INC

MEDICARE: SOCA IMAGING INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154570356
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOCA IMAGING INC
Provider Business Mailing Address
First Line : 8100 ROYAL PALM BLVD STE 102
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33065-5733
Country : US
Telephone Number : 954-341-2325
Fax Number : 954-341-6926
Provider Business Practice Location Address
First Line : 8110 ROYAL PALM BLVD STE 100
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33065-5742
Country : US
Telephone Number : 954-341-2325
Fax Number : 954-341-6926
Authorized Official
Title or Position : PRESIDENT
Name : MR. MILES E GILMAN
Credential :
Telephone Number : 305-665-1197
Provider Enumeration Date : 09/11/2008
Last Update Date : 09/11/2008

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Directions to “SOCA IMAGING INC ” Practice Location

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